Migraine, Mitral Valve Prolapse, and Platelet Aggregation

Mitral valve prolapse (MVP) is one of the most common cardiac valve anomalies of adult age [28]. Cardioembolically-related cerebrovascular events represent an especially serious accompaniment of MVP. In patients under 45 years of age about 30% of transient ischemic attacks (TIAs) and cerebral infarctions are reported to be due to an MVP [4, 5, 44]. There is a strikingly high incidence of migraine among MVP patients [1, 35]. The focal neurologic deficits associated with hemiplegic migraine [10] resemble TIA symptoms which may occur in MVP patients. Furthermore, the risk of cerebral infarction in migraine patients, especially in patients with a hemiplegic migraine, is reported to be higher than in the normal population [22,38,39]. It is not uncommon for migraine patients to demonstrate disturbed platelet function in the form of enhanced platelet adhesion and aggregation even in the headache-free interval [30]. Such a platelet dysfunction, which is generally regarded as a risk factor for cerebrovascular complications, has been observed in MVP patients as well [19, 46, 47].